Question

A patient is admitted to the hospital with possible bacterial meningitis. During the initial assessment, the nurse questions the patient about a recent history of

a. mosquito or tick bites
b. chickenpox or measles
c. cold sores or fever blisters
d. an upper respiratory infection

Answer 1

In the case of potential bacterial meningitis, the nurse should inquire about a recent upper respiratory infection during the initial assessment, as such infections can serve as a gateway for bacteria to access the CNS. Mosquito or tick bites, and other illness like chickenpox, herpes, or measles, are less directly relevant to bacterial meningitis, although they can be related to viral meningitis or other CNS infections.

Step-by-step explanation:

Assessment for Potential Bacterial Meningitis

The nurse's initial assessment involves questioning the patient about specific exposures relevant to bacterial meningitis. Given the nature of the condition, which is an infection of the cerebrospinal fluid (CSF) causing inflammation of the meninges, it is critical to ascertain recent upper respiratory infections. These infections can serve as a gateway for bacteria to access the central nervous system (CNS). Bacterial meningitis is often caused by bacteria that spread from structures within the upper respiratory tract, such as the oropharynx and nasopharynx. Therefore, the nurse should inquire about recent symptoms of an upper respiratory infection, as it could be highly indicative of a connection to the patient's current state.

While mosquito or tick bites are related to arboviral encephalitis and Lyme disease respectively, which can also affect the CNS, they are less commonly associated with bacterial meningitis. Likewise, cold sores or fever blisters are typically indicative of herpes simplex virus, not a bacterial etiology. Additionally, while chickenpox or measles could potentially lead to viral meningitis, in the context of bacterial meningitis, these conditions would be relevant only if they caused a secondary bacterial infection.

Diagnosing meningitis early and accurately is imperative due to its rapid progression and potential severity. After an upper respiratory infection, bacteria may enter the bloodstream, leading to meningitis. Antibiotics are a mainstay of treatment, and in some cases, prophylactic antibiotics or vaccines may be necessary for close contacts when specific bacteria like N. meningitidis are identified.